CompuGroup Medical US
Intelligent IT in the Healthcare Sector

Since the Affordable Care Act (ACA) was launched, revenue cycle management in the healthcare sector has changed drastically. Between MACRA, ICD-10, and Accountable care, it has become the healthcare sector’s top priority to have an efficient revenue cycle management system so that financial pressures that come from regulations can be handled seamlessly. As the healthcare revenue cycle continues to evolve dynamically, healthcare professionals tend to face numerous challenges—from billing to coding errors, and failure in having policies and processes intact. With a comprehensive portfolio of cutting-edge IT solutions for improving the revenue cycle, CompuGroup Medical US (CGM US),an eHealth provider, steps in to provide practices expedient and cost-effective billing and coding solutions. As a publically traded company, CompuGroup Medical US offers electronic health records to innovative practice management solutions. “Our firm’s Revenue Cycle Management (RCM) solution—an in-house claims management tool—automates and streamlines challenges faced by practices,” asserts Benedikt Brueckle, CEO of CGM US.

Delivering an end-to-end revenue cycle management, the firm’s spectrum of solutions includes educating the practice on business procedures and processes—from adequately coding to efficiently billing—thereby helping identify gaps. CGM US focuses explicitly on two components: product and service. The product component is delivered with an onsite training package that the firm implements and offers virtually. With regards to service, organizations receive a dedicated accounts manager, a diligent analytics manager, and a billing and coding team. The firm’s success is measured by the way the practice operates, as well as the cash flow of the practice. “Implementation of these solutions has changed over time because with complexities taking over additional checks and balance processes, a unified team approach based upon specialty had to be instilled by us,” elucidates Brandon Franklin, VP of RCM at CGM US.

Following a ‘single point of contact model,’ the firm focuses on small to medium-sized clients and large clients such as hospitals.

Connecting doctors, hospitals, health insurers, pharmacists, and other healthcare stakeholders, the firm assures optimized care, improved efficiency, increased patient satisfaction, and enhanced profitability

Therefore, by connecting hospitals, doctors, health insurers, pharmacists, and other healthcare stakeholders, the firm assures optimized care, improved efficiency, increased patient satisfaction, and enhanced profitability. CGM US also focuses on recovering revenues, accelerating payments, reporting, and visibility of performances, and custom reporting and analytics. The firms’ experienced teams ensure seamless transactions apart from developing customized strategies to meet objectives.

However, since every client is different, the firm segregates their requirements and caters to their needs accordingly. One such client was a hospital in Northern California that had a multitude of different issues, the primary one being staffing. They found it quite challenging to find highly qualified employees that understood coding based on the new complexities within the healthcare sector. Moreover, the hospital also had multiple different data sources and sets without a way to aggregate it; hence, they could not provide a strong day-to-day analytical overview of where they were at, what they needed to do, and how to get to where they wanted. CompuGroup Medical US stepped in to help the hospital.

Initially, the firm retained some of the hospital staff and provided an onsite as well as a remote solution for them. It implemented software and a data analytics package, and began educating the existing staff on billing procedures. The firm began normalizing and structuring the existing billing processes to identify gaps, and also started coaching providers on coding those gaps to maximize revenue based on current standards. Once the processes were in place, the hospital was provided with ongoing reports based on KPIs and metrics. This brought about continuous improvement in the hospital’s work and increased their billing by roughly 21 percent, while maintaining the same level of cost.

Currently, the firm is looking to double the FTE count within the Phoenix marketplace. In addition, it is looking to expand in regional areas across the US—from the Southeast to the Northeast, the Midwest, to the Southwest—for local facilities that will support clients within a three-hour radius, adding more value. “We are also looking to enhance our next-generation EHR and practice management software as well as its backend billing desk to support all its revenue cycle management,” concludes Franklin.